Will Starting HIV Treatment With a Low CD4 Count Hurt My Lifespan?

Question

Hi,

I was diagnosed with Burkitt's Lymphoma in 2010. That is also when I discovered that I was HIV +. When I was diagnosed, my CD4 count was 70. Treatment was successful, I am considered cured, and my CD4 count is consistently in the 500's. I read recently that, even though longevity is increasing for HIV + people, people who begin treatment with a low CD4 count will probably live a shorter period of time. Do you feel this is true?

Answer

First, you have had a fabulous response to both HIV treatment and lymphoma treatment. Yes, there are published studies which suggest people with low CD4 counts (in general < 200) when they start HIV treatment could live a shorter period. But this depends on many factors including age at infection, other ongoing medical conditions, family history and underlying genetics, and lifestyle decisions (i.e.e, smoking, etc.), among others. In addition, the longer one continues to maintain and undetectable HIV viral load, and the higher the CD4 count is maintained (say in the normal range), can also mitigate the effect of low CD4 count prior to treatment on longevity.